TOPLINE:

Ultrasound demonstrated a strong correlation and agreement with CT in assessing the diameter of the ascending aorta in patients with giant cell arteritis (GCA), supporting its use as an effective first-line tool for routine screening for thoracic aneurysms in this population.

METHODOLOGY:

• Researchers conducted a cross-sectional study of 140 patients with GCA (mean age, 71.1 years; 62.9% women) at Martina Hansens Hospital, Bærum, Norway, between September 2017 and June 2024.
• The analysis included the comparison of ultrasound and CT measurements of the diameter of the ascending aorta, with scans performed within 6 months of each other. An aneurysm was defined as a diameter of ≥ 40 mm in both the ascending and descending aorta.
• Patients were categorised as those with cranial GCA (34.3%), large-vessel GCA (19.3%), and mixed GCA (46.4%), with a mean follow-up duration of 47.8 months from diagnosis to the last aorta imaging.
• A prospective follow-up study of a cohort of 40 patients who underwent baseline imaging within 6 months of diagnosis and subsequent follow-up imaging at various timepoints was performed to assess longitudinal changes in the diameter of the aorta.

TAKEAWAY:

• A strong correlation was observed between ultrasound and CT measurements of the ascending aorta (Spearman's rho, 0.801; intraclass correlation coefficient, 0.85; P < .001 for both), with a mean difference of 1.8 mm.
• Ascending aortic aneurysms were detected in 26.4% of patients, with a median disease duration of 25 months, and men showed more than fourfold higher chances of developing this condition (odds ratio, 4.19; P < .001).
• Among the 40 patients who were prospectively followed up, 17.5% developed ascending aortic aneurysms during a mean follow-up of 54 months (P = .75).
• The mean diameter of the ascending aorta increased by 2.6 mm at 54 months of follow-up from the baseline value (P < .01).

IN PRACTICE:

"Ultrasound yields results comparable to CT's in assessing the ascending aorta in patients with GCA," the authors wrote. "Given ultrasound's accessibility, cost-effectiveness, and lack of radiation, it could be a reasonable first-line tool for routine screening and monitoring of aortic aneurysms in this patient group," they suggested.

SOURCE:

This study was led by Anne C. Bull Haaversen, MD, Martina Hansens Hospital, Bærum, Norway. It was published online on September 30, 2025, in Arthritis Care & Research.

LIMITATIONS:

The real-life setting of the study may have introduced methodological variability, with ultrasound measurements subject to operator-dependent factors and CT data potentially influenced by differences in scan quality, phase of acquisition, contrast use, and measurement technique. This study was also limited by the fact that one ultrasonographer was not blinded to some CT scan results, potentially introducing bias. Additionally, varying imaging intervals and modalities in the prospective study, along with a relatively small patient cohort, affected the robustness of the findings.

DISCLOSURES:

This study did not receive any specific funding from any public, commercial, or not-for-profit bodies. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.